title: Docetaxel as a vital option for corticosteroid-refractory prostate cancer.
abstract: OBJECTIVE
  The efficacy of docetaxel (TAX) chemotherapy for corticosteroid-refractory refractory prostate cancer (CRPC) is uncertain.
  
  
  METHODS
  We retrospectively reviewed outcomes of 51 men with corticosteroid-refractory CRPC treated at our institute. Of them, 24 men had received only dexamethasone (DEX) before the approval of TAX (historical control). The remaining 27 men who had already become DEX refractory on the approval of TAX underwent TAX plus DEX.
  
  
  RESULTS
  The median overall survival for men treated with TAX plus DEX (17.6 months) was significantly longer than men with DEX (8.1 months, P = 0.021). On univariate analysis, performance status, lactate dehydrogenase (LDH), alkaline phosphatase (ALP), prostate specific antigen (PSA), and TAX therapy were significant factors for overall survival. Of these, performance status and TAX therapy remained as the significant factor on multivariate analysis. No significant benefit was detected for men with advanced disease such as poorer performance status, elevated LDH, elevated ALP, or high PSA. Grades 3, 4 toxicities including anemia (19%), leukocytopenia (26%), and neutropenia (26%) were found in TAX cases.
  
  
  CONCLUSIONS
  Our results suggest that TAX would be a vital option for DEX refractory CRPC possibly with more efficacy for less advanced stages.
authors.affiliation: Department of Urology, The University of Tokyo Hospital, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan. kumeh-uro@h.u-tokyo.ac.jp
authors.forename: Haruki
authors.initials: H
authors.lastname: Kume
authors.forename: Motofumi
authors.initials: M
authors.lastname: Suzuki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Fujimura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fukuhara
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Enomoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishimatsu
authors.forename: Akira
authors.initials: A
authors.lastname: Ishikawa
authors.forename: Yukio
authors.initials: Y
authors.lastname: Homma
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm; D006801:Humans; D017567:Karnofsky Performance Status; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology*; D012189:Retrospective Studies; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D043823:Taxoids; D000077143:Docetaxel; D003907:Dexamethasone; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase; D017430:Prostate-Specific Antigen